* Your Company: This field is required.

 

Halyard Account #:   ?

 

Branch Name: Please enter only alpha-numeric characters are allowed.

 

* State: Please enter only alpha-numeric characters are allowed.

 

*Street Address: Please enter only alpha-numeric and some special characters like ( . , - )are allowed.

 

* Country: US Canada This field is required.

 

* City: Please enter only alpha-numeric characters are allowed.

 

* Zip: Please enter only alpha-numeric characters are allowed.

 

* Your Name: Please enter only alpha-numeric characters are allowed.

* Email Address: Please enter a valid email address.

* Fax Number: Please enter only digits.

Your Back-up Contact: Please enter only alpha-numeric characters are allowed.

* Re-enter Email Address: Please enter a valid email address.

* Phone Number: Please enter only digits.

Details of Overstock Return - OR - Listing of Requested Overstock Return

Enter the HYH Catalog Number, quantity ordered and received. Then, click on the drop down box and indicate the type of discrepancy and requested action to be taken.

File attach (Upload size limit=5MB. jpeg, gif, png, pdf, xls and doc files)  ?

***To expedite the processing of your return request, please enter the complete code for Ballard product, OR the 5-digit code PLUS the 2-digit dash code for all K-C Supply product***

When you have completed this form, click "submit" to send your overstock return request to Halyard.

Please note that upon successful transmission of your overstock return request, you will receive an automatic confirmation in your email inbox. If you do not receive a confirmation, please contact Customer Service at Overstock@hyh.com This may indicate that your overstock return request did not transmit successfully.

Please enter only digits.